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September 25, 2018 by Tomi Bergström et al | Psychiatry Research

The family-oriented open dialogue approach in the treatment of first-episode psychosis: Nineteen–year outcomes

Tomi Bergström, Jaakko Seikkula, Birgitta Alakare, Pirjo MäkiPäivi Köngäs-Saviaro, Jyri J.Taskila, Asko Tolvanen,  Jukka Aaltonen

Highlights

• The long-term outcomes of a network-based treatment of psychosis were studied.
• The approach was associated with a decreased need for treatment, and with better work capability.
• Over decades, the outcomes were more sustained than with other FEP treatments.
• The approach showed no significant difference in its ability to prevent suicides.

Abstract

Open Dialogue (OD) is a family-oriented early intervention approach which has demonstrated good outcomes in the treatment of first-episode psychosis (FEP). Nevertheless, more evidence is needed. In this register-based cohort study the long-term outcomes of OD were evaluated through a comparison with a control group over a period of approximately 19 years. We examined the mortality, the need for psychiatric treatment, and the granting of disability allowances. Data were obtained from Finnish national registers regarding all OD patients whose treatment for FEP commenced within the time of the original interventions (total N = 108). The control group consisted of all Finnish FEP patients who had a follow-up of 19–20 years and who were guided to other Finnish specialized mental healthcare facilities (N = 1763). No difference between the samples was found regarding the annual incidence of FEP, the diagnosis, and suicide rates. Over the entire follow-up, the figures for durations of hospital treatment, disability allowances, and the need for neuroleptics remained significantly lower with OD group. Findings indicated that many positive outcomes of OD are sustained over a long time period. Due to the observational nature of the study, randomized trials are still needed to provide more information on effectiveness of approach.

Source: ScienceDirect.com/science/article/pii/S0165178117323338

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